Mechanisms of bone metastases of breast cancer.
Mechanisms of bone metastases of breast cancer.
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DOI：
10.1677/erc-09-0012
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发表时间：
2009-09
影响因子：
3.9
通讯作者：
Makhoul I
中科院分区：
文献类型：
--
作者：
Suva LJ;Griffin RJ;Makhoul I
癌症的发展是一个由基因改变驱动的多步骤过程，这些改变导致正常人类细胞逐渐转变为高度恶性的衍生品。癌症细胞增殖表型的改变涉及一系列分子事件，这些事件往往导致远处转移的发展。就乳腺癌而言，骨骼是最常见的转移部位之一。尽管骨转移具有重要的临床意义，但其潜在的细胞和分子机制仍不清楚。尽管我们对肿瘤细胞表型的了解取得了进展，人们越来越关注肿瘤微环境的贡献，最近人们对肿瘤增殖细胞(即所谓的癌症干细胞)的作用重新产生了兴趣，这些细胞可能是骨髓中产生的正常干细胞的来源或相关细胞，但许多重要的问题仍然没有答案。因此，需要对影响整个多步骤转移级联的微环境和肿瘤表型的影响有更全面的了解。本文就肿瘤异质性、肿瘤增殖细胞、乳腺癌骨转移的微环境以及目前预防和治疗转移性乳腺癌的多种内分泌治疗方法作一综述。
Cancer development is a multistep process driven by genetic alterations that elicit the progressive transformation of normal human cells into highly malignant derivatives. The altered cell proliferation phenotype of cancer involves a poorly characterized sequence of molecular events, which often result in the development of distant metastasis. In the case of breast cancer, the skeleton is amongst the most common of metastatic sites. In spite of its clinical importance, the underlying cellular and molecular mechanisms driving bone metastasis remain elusive. Despite advances in our understanding of the phenotype of cancer cells, the increased focus on the contribution of the tumor microenvironment and the recent revival of interest in the role of tumor propagating cells (so called cancer stem cells) that may originate or be related to normal stem cells produced in the bone marrow, many important questions remain unanswered. As such, a more complete understanding of the influences of both the microenvironment and tumor phenotype that impact the entire multi-step metastatic cascade is required. In this review the importance of tumor heterogeneity, tumor propagating cells, the microenvironment of breast cancer metastasis to bone as well as many current endocrine therapies for the prevention and treatment of metastatic breast cancer are discussed.